Association between inflammatory indexes and erectile dysfunction in U.S. adults: National Health and Nutrition Examination Survey 2001-2004

Abstract

Background The association of inflammatory biomarkers with erectile dysfunction (ED) is still largely unknown. Aim The study sought to explore the association of inflammatory biomarkers with ED in U.S. adults. Methods Participant data for this study were extracted from the National Health and Nutrition Examination Survey, and individuals that lacked information on clinical variables were excluded. Dose-response curve analysis was applied to explore the association of inflammatory biomarkers with ED prevalence. The confounders were adjusted for with weighted logistic regression analysis. We employed 1:1 propensity score matching to eliminate the effects of clinical variables to confirm the reliability of the results. Outcomes ED prevalence was investigated with potential risk factors. Results A total of 2331 men ≥20 years of age who participated in the National Health and Nutrition Examination Survey 2001-2004 were included in this study. Compared with individuals without ED, ED cohort displayed higher levels of neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, systemic immune-inflammatory index, and systemic inflammation response index. Dose-response curve analysis indicated ED prevalence increased with the increase of platelet-to-lymphocyte ratio, systemic immune-inflammatory index, and systemic inflammation response index. Weighed logistic regression analysis revealed neutrophil-to-lymphocyte ratio was positively associated with ED. The reliability of the results was confirmed by 1:1 propensity score matching reanalysis. Clinical Implications Individuals with chronic inflammatory conditions should be alert for the development of ED. Strengths and Limitations It is a large controlled study to investigate the relationship between inflammatory indexes and ED. However, it is a cross-sectional study and it lacks an accurate assessment of the degree of ED. Conclusion Inflammatory biomarkers were associated with ED prevalence.

Higher systemic immune-inflammation index is associated with increased risk of erectile dysfunction: Result from NHANES 2001–2004

“…In an environment predominantly characterized by proinflammatory responses, nitric oxide bioavailability is compromised, resulting in impaired vasodilation. This impairment can be attributed to the suppression of endothelial nitric oxide synthase expression and the overproduction of reactive oxygen species, ultimately leading to endothelial dysfunction [ 17 ] Understanding the intricate interplay between inflammation and ED is crucial for advancing effective treatment strategies and interventions.…”

“…When investigating the association between SII and ED, Chunhui Liu et al did not observe any significant relationship in their multivariate logistic regression model. [ 17 ] The inconsistent findings could potentially be attributed to the exclusion of a substantial number of study participants during the analysis of various inflammatory indicators. This limitation may have contributed to the lack of association observed between SII and ED.…”

Association between polyunsaturated fatty acid intake and the prevalence of erectile dysfunction: A cross-sectional analysis of the NHANES 2001–2004

“…Participants were given four options, “almost always or always able”, “usually able”, “sometimes able” and “never able”. Unlike previous definitions of ED through answering the above question as “never able” or “sometimes able” or answering “yes” to the question “Have you ever had ED?” [ 13 , 24 ], herein, a stricter definition of ED was used: Participants who answered “almost always or always able” were identified as having no ED, and the rest were identified as having ED [ 14 , 25 ].…”

“…Inflammation not only affects endothelial cells but also contributes to the pathogenesis of metabolic syndromes, all of which promote ED [ 9 ]. Chunhui Liu et al found that the prevalence of ED increased with increasing inflammatory indices [ 13 ]. A study by Youssef MK Farag showed that vitamin D deficiency was independently associated with a higher prevalence of ED and that vitamin D may improve ED through improving inflammation and endothelial function [ 14 ].…”